There is widespread variation in the instance and quality of meaningful patient involvement across the 42 Integrated Care Systems (ICSs) of NHS England. This is seen throughout the structures, policies and processes of the ICSs, from the omission of patient representatives on decision-making bodies—such as Integrated Care Boards (ICBs)—to the neglect of clear consultation when decisions are made concerning a patient’s care.
This report present the results of research and analysis conducted by the Medical Technology Group (MTG). It shows that where a patient lives is the biggest determinant to whether they are involved in their care meaningfully, or at all. It makes recommendations for the Government, NHS England and ICS's on the approach that should be taken to ensure meaningful patient engagement.
- The Department of Health and Social Care should publish guidance that requires patient representation on ICBs and the annual reporting of patient involvement and representation in ICB activity.
- The Care Quality Commission should be given more freedom to scrutinise the level of patient involvement being carried out by ICSs and ICBs. This should also take into consideration the structures for accountability and reporting on how patient feedback is considered.
For NHS England
- NHS England should better incentivise ICBs to involve patients within decision-making structures.
- NHS England should encourage ICS leaders to come together to discuss best practice for patient involvement.
- NHS England should support ICBs to implement their ‘Working with People and Communities Strategy’ and promote the sharing of best practice nationally.
For Integrated Care Systems
- ICBs should involve patient representatives on boards and on committees.
- ICBs should ensure that patient feedback loops are properly established and practiced allowing for patient input to formally contribute to the development of policy. Patient feedback should be anonymous and cover all forms of care.
- ICBs should ensure that there is a rolling patient satisfaction survey for patient treatments. These should be used as a management tool to improve services.
- ICBs should include a standing item on their Board meetings to review how effectively they consider the patient voice when making decisions regarding the delivery of care in their local area.
- ICSs and ICBs should first identify Voluntary, Community and Social Enterprises (VCSEs), review how they involve VCSEs, and emphasis should be placed on working collaboratively with community bodies.